Natural history of low-risk branch-duct intraductal papillary mucinous neoplasms and indeterminate pancreatic cysts: Implications on surveillance intervals by cyst size

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2024-12, Vol.24 (8), p.1332-1339
• Main Authors: Tan, Hwee-Leong, Hee, Jonathan, Wu, Jania, Lim, Grace R.S., Tan, Damien M.Y., Low, Albert S., Thng, Choon-Hua, Koh, Ye-Xin, Goh, Brian K.P.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - diagnostic imaging; Adenocarcinoma, Mucinous - epidemiology; Adenocarcinoma, Mucinous - pathology; Adult; Aged; Branch-duct intraductal mucinous neoplasm; Carcinoma, Pancreatic Ductal - diagnostic imaging; Carcinoma, Pancreatic Ductal - pathology; Cohort Studies; Female; Humans; IPMN; Low-risk; Male; Middle Aged; Pancreatic cyst; Pancreatic Cyst - diagnostic imaging; Pancreatic Cyst - pathology; Pancreatic Intraductal Neoplasms - diagnostic imaging; Pancreatic Intraductal Neoplasms - pathology; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - epidemiology; Pancreatic Neoplasms - pathology; Retrospective Studies; Surveillance
• ISSN: 1424-3903; 1424-3911; 1424-3911
• DOI: 10.1016/j.pan.2024.11.014

The optimal surveillance strategy for low-risk branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) remains unclear. We aim to evaluate the natural history of low-risk BD-IPMN/indeterminate pancreatic cysts to determine optimal surveillance intervals. We conducted a retrospective cohort study of patients with radiologically-diagnosed low-risk BD-IPMN/indeterminate pancreatic cysts from 1998 to 2021 at a tertiary referral center. Low-risk BD-IPMN, worrisome features (WF) and high-risk stigmata (HRS) were defined as per existing guidelines. Patients were grouped into three categories based on cyst size at diagnosis: